The 340B Program: Benefits and Limitations

This in progress study reviews challenges and successes associated with implementing a 340B program at Marshall Health and Cabell Huntington Hospital (CHH) in Huntington, West Virginia. CHH qualified as a participant in the 340B program because it has met qualification as a disproportionate share hospital (DSH). The site has also been able to open two outpatient pharmacies to serve the targeted patient population. The pharmacies have also been able to use savings from the program to embed clinical pharmacists into the physician care areas to provide medication therapy management services including discharge counselling, disease state management services, patient financial assistance in paying for drugs, and coordination of care. We will also explore other benefits achieved with other Marshall 340B qualified covered entities

MACRA and Rural Hospitals

Introduction: Every year, the cost of healthcare within the United States has continued to increase while the quality of patient care has decreased. To reconstruct the delivery of care, Congress has introduced the Medicare Access and CHIP Reauthorization Act of 2015 which has reinvented Medicare physician reimbursement systems. The purpose of this research was to study the Medicare Access and CHIP Reauthorization Act and its implementation to determine how it would financially impact rural hospitals. Methodology: The methodology for this study consisted of a qualitative literature review. Twenty-seven research publications were utilized throughout the study. Data limited to the English language from the years 2015 through 2017 were included in the review. Results: Two reimbursement pathways termed Merit-Based Incentive Payment Systems and Alternative Payment Models have been created for physicians under the Medicare Access and CHIP Reauthorization Act. Each reimbursement pathway has rewards and penalties that affect physicians and healthcare organizations financially. In addition to the pathways, financing and competition among facilities created by the act have been expected to impact physicians and healthcare organizations. Discussion/Conclusion: Although the long-term effects of the Medicare Access and Reauthorization Act of 2015 have not been able to be studied, physicians and healthcare organizations such as rural hospitals have been expected to be impacted significantly. Rural hospitals have been set to receive reduced government reimbursements and have been predicted to compete poorly with larger hospitals and corporations. The payment tracks available through the act have been projected to impact solo and small practice physicians negatively; therefore, hospitals have been expected to have to provide support and assistance to local clinicians

Burnout syndrome and nurse-to-patient ratio in the workplace

Introduction: Burnout among Registered Nurses has been a great concern within the U.S. healthcare system and has been reported in many hospitals. Nurse Burnout has been defined as a chronic response to work-related stress comprising three components or dimensions: emotional exhaustion, depersonalization, and personal accomplishment. The purpose of this research was to analyze the nurse-to-patient ratio to determine how it affects the psychological, mental, emotional health and the nurse overall productivity in the workplace. Methodology: The methodology was a review of literatures and a semi-structured interview. There were four primary databases and one website used in this research, and 31 articles were consulted for this literature review. Results: Study on Psychological, Mental, and Emotional Health and Nurse Productivity in Burnout Syndrome Regarding Nurse-to-Patient Ratio Discussion: The expert’s observed causes for nurse dissatisfaction in their position and general fatigue were attributed to mismanagement of personnel and resources, lack of follow through, extended shifts and stretched personal requirements all of which lead to feelings of burnout. Conclusion: The nurse-patient ratio is a direct determinate of the effects of psychological, mental, emotional health and nurse productivity in the workplace which also determines the patients’ overall health

Healthcare Facilities: Another Target for Ransomware Attacks

Ransomware is a type of malware used by cyber criminals who encrypt files and then extort money in return for unlocking those files. Without adequate disaster recovery and backup plans, many businesses are forced to pay the ransom. We examine recent ransomware infections in healthcare settings, the liabilities and cost associated with such infections, and discuss possible risk mitigation tactics. Risks associated with ransomware attacks on healthcare facilities include financial, future business loss and damage to reputation. Healthcare facilities should have a disaster plan with adequate data backups and educate employees who are the usual sources of ransomware attacks

The Emerging Issue of Hepatitis C Virus in the United States and in West Virginia

Introduction: Hepatitis C virus (HCV) is one of the most significant public health problems currently facing the U.S., Especially in West Virginia. If it is undetected and left untreated, the likelihood of sustaining a treatment response decreases. While early identification has been identified as a critical focus in trying to obtain better health outcomes, new drug treatments appear promising, although somewhat expensive. West Virginia, a predominantly rural state, is beginning to face a mounting financial crisis due to HCV. Purpose of the Study: The purpose of this study was to examine the effects of early identification and treatment for patients infected with HCV given the financial restraints in the healthcare delivery in the United States and in particular in West Virginia. Methodology: The methodology for this qualitative study was a literature review. Seven electronic databases were utilized with a total of 50 scholarly articles being referenced for this research. Additionally, it was performed a semi-structured interview with an Infectious Disease physician. Results: The literature review examined several studies that evaluated acute and chronic HCV identification process and Implications for this population. Also, the semi-structured interview revealed more insight into HCV identification and treatment. The results demonstrated potential to increasing QALYs along with highlighting restrictions of current payment for procedures. Discussion/Conclusion: The results of the literature review did suggest that early intervention programs are needed to decrease the incidence and Prevalence of HCV. Several practical implications included the possibility of obtaining funding for early intervention Programs through grants and the modification of legislation to benefit vulnerable populations. Improving testing, Simplifying screening, and data collection through enhanced surveillance reporting, along with an expanded specialized clinical workforce would be of benefit and represent some cost savings

C (2013) A review of Radio Frequency Identification Technologies and Impacts on the Hospital Supply Chain

EXECUTIVE SUMMARY Supply costs are the second largest expenditure in hospitals, accounting for more than one third of the average operating budget. RFID technology can reduce these costs, improve patient safety, and supply chain management by increasing the ability to track and locate equipment, as well as monitoring theft prevention, distribution management, and patient billing. Findings of this study have shown that the application of RFID on medical equipment and supplies have resulted in efficiency increase in healthcare with lower costs and increased quality services. Even though the cost of RFID implementation is decreasing, the total expenditures are still significant and the return on investment remains unclear